Glucagon-like peptide-1 agonists combined with sodium-glucose cotransporter-2 inhibitors reduce weight in type 1 diabetes.
Humans
Hypoglycemic Agents
/ therapeutic use
Diabetes Mellitus, Type 2
/ drug therapy
Diabetes Mellitus, Type 1
Sodium-Glucose Transporter 2 Inhibitors
/ pharmacology
Glycated Hemoglobin
Retrospective Studies
Glucagon-Like Peptide-1 Receptor
/ agonists
Glucagon-Like Peptide 1
/ therapeutic use
Weight Loss
Glucose
Sodium
Journal
Obesity (Silver Spring, Md.)
ISSN: 1930-739X
Titre abrégé: Obesity (Silver Spring)
Pays: United States
ID NLM: 101264860
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
revised:
02
11
2022
received:
12
09
2022
accepted:
22
11
2022
entrez:
22
2
2023
pubmed:
23
2
2023
medline:
25
2
2023
Statut:
ppublish
Résumé
This study evaluated whether adding sodium-glucose cotransporter-2 inhibitors (SGLT2i) and/or glucagon-like peptide-1 receptor agonists (GLP1-RA) to insulin reduced weight and glycemia in people with type 1 diabetes. This retrospective analysis of electronic health records evaluated 296 people with type 1 diabetes over 12 months after medications were first prescribed. Four groups were defined: control n = 80, SGLT2i n = 94, GLP1-RA n = 82, and combination of drugs (Combo) n = 40. We measured changes at 1 year in weight and glycated hemoglobin (HbA1c). The control group did not have changes in weight or glycemic control. The mean (SD) percentage weight loss after 12 months was 4.4% (6.0%), 8.2% (8.5%), and 9.0% (8.4%) in the SGLT2i, GLP1-RA, and Combo groups, respectively (p < 0.001). The Combo group lost the most weight (p < 0.001). The HbA1c reduction was 0.4% (0.7%), 0.3% (0.7%), and 0.6% (0.8%) in the SGLT2i, GLP1-RA, and Combo groups, respectively (p < 0.001). The Combo group had the biggest improvements in glycemic control and total and low-density lipoprotein cholesterol compared with baseline (all p < 0.01). Severe adverse events were similar between all the groups, with no increased risk of diabetic ketoacidosis. The SGLT2i and GLP1-RA agents on their own improved body weight and glycemia, but combining the medications resulted in more weight loss. Treatment intensification appears to result in benefits with no difference in severe adverse events.
Substances chimiques
Hypoglycemic Agents
0
Sodium-Glucose Transporter 2 Inhibitors
0
Glycated Hemoglobin
0
Glucagon-Like Peptide-1 Receptor
0
Glucagon-Like Peptide 1
89750-14-1
Glucose
IY9XDZ35W2
Sodium
9NEZ333N27
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
716-723Informations de copyright
© 2023 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society.
Références
DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes. Lancet. 2018;391:2449-2462.
Nathan DM, Cleary PA, Backlund J-YC, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353:2643-2653.
Malkani S, Kotwal A. Frequency and predictors of self-reported hypoglycemia in insulin-treated diabetes. J Diabetes Res. 2017;2017:7425925. doi:10.1155/2017/7425925
McCall AL, Farhy LS. Treating type 1 diabetes: from strategies for insulin delivery to dual hormonal control. Minerva Endocrinol. 2013;38:145-163.
Russell-Jones D, Khan R. Insulin-associated weight gain in diabetes--causes, effects and coping strategies. Diabetes Obes Metab. 2007;9:799-812.
Larger E. Weight gain and insulin treatment. Diabetes Metab. 2005;31(4 Pt 2):4s51-4s56.
McCrimmon RJ, Henry RR. SGLT inhibitor adjunct therapy in type 1 diabetes. Diabetologia. 2018;61:2126-2133.
Purnell JQ, Zinman B, Brunzell JD; DCCT/EDIC Research Group. The effect of excess weight gain with intensive diabetes mellitus treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes mellitus: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Trial (DCCT/EDIC) study. Circulation. 2013;127:180-187.
McCoy RG, Van Houten HK, Karaca-Mandic P, Ross JS, Montori VM, Shah ND. Second-line therapy for type 2 diabetes management: the treatment/benefit paradox of cardiovascular and kidney comorbidities. Diabetes Care. 2021;44:2302-2311.
Holst JJ, Vilsbøll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009;297:127-136.
Nadkarni P, Chepurny OG, Holz GG. Regulation of glucose homeostasis by GLP-1. Prog Mol Biol Transl Sci. 2014;121:23-65.
Hasan FM, Alsahli M, Gerich JE. SGLT2 inhibitors in the treatment of type 2 diabetes. Diabetes Res Clin Pract. 2014;104:297-322.
Zheng SL, Roddick AJ, Aghar-Jaffar R, et al. Association between use of sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 agonists, and dipeptidyl peptidase 4 inhibitors with all-cause mortality in patients with type 2 diabetes: a systematic review and meta-analysis. JAMA. 2018;319:1580-1591.
Mathieu C, Zinman B, Hemmingsson JU, et al; ADJUNCT ONE Investigators. Efficacy and safety of liraglutide added to insulin treatment in type 1 diabetes: the ADJUNCT ONE treat-to-target randomized trial. Diabetes Care. 2016;39:1702-1710.
Dejgaard TF, von Scholten BJ, Christiansen E, et al; ADJUNCT ONE and ADJUNCT TWO Investigators. Efficacy and safety of liraglutide in type 1 diabetes by baseline characteristics in the ADJUNCT ONE and ADJUNCT TWO randomized controlled trials. Diabetes Obes Metab. 2021;23:2752-2762.
Dandona P, Mathieu C, Phillip M, et al; DEPICT-1 Investigators. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes (DEPICT-1): 24 week results from a multicentre, double-blind, phase 3, randomised controlled trial. Lancet Diabetes Endocrinol. 2017;5:864-876.
Mathieu C, Dandona P, Gillard P, et al; DEPICT-2 Investigators. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes (the DEPICT-2 study): 24-week results from a randomized controlled trial. Diabetes Care. 2018;41:1938-1946.
Dandona P, Mathieu C, Phillip M, et al; DEPICT-1 Investigators. Efficacy and safety of Dapagliflozin in patients with inadequately controlled type 1 diabetes: the DEPICT-1 52-week study. Diabetes Care. 2018;41:2552-2559.
Buse JB, Garg SK, Rosenstock J, et al. Sotagliflozin in combination with optimized insulin therapy in adults with type 1 diabetes: the North American inTandem1 study. Diabetes Care. 2018;41:1970-1980.
Garg SK, Henry RR, Banks P, et al. Effects of sotagliflozin added to insulin in patients with type 1 diabetes. N Engl J Med. 2017;377:2337-2348.
Kuhadiya ND, Malik R, Bellini NJ, et al. Liraglutide as additional treatment to insulin in obese patients with type 1 diabetes mellitus. Endocr Prac. 2013;19:963-967.
Guyton J, Jeon M, Brooks A. Glucagon-like peptide 1 receptor agonists in type 1 diabetes mellitus. Am J Health Syst Pharm. 2019;76:1739-1748.
Harrison LB, Mora PF, Clark GO, Lingvay I. Type 1 diabetes treatment beyond insulin: role of GLP-1 analogs. J Investig Med. 2013;61:40-44.
Taylor SI, Blau JE, Rother KI, Beitelshees AL. SGLT2 inhibitors as adjunctive therapy for type 1 diabetes: balancing benefits and risks. Lancet Diabetes Endocrinol. 2019;7:949-958.
Rosenstock J, Marquard J, Laffel LM, et al. Empagliflozin as adjunctive to insulin therapy in type 1 diabetes: the EASE trials. Diabetes Care. 2018;41:2560-2569.
Palanca A, van Nes F, Pardo F, Ampudia Blasco FJ, Mathieu C. Real-world evidence of efficacy and safety of SGLT2 inhibitors as adjunctive therapy in adults with type 1 diabetes: a European two-center experience. Diabetes Care. 2022;45:650-658.
Kuhadiya ND, Dhindsa S, Ghanim H, et al. Addition of liraglutide to insulin in patients with type 1 diabetes: a randomized placebo-controlled clinical trial of 12 weeks. Diabetes Care. 2016;39:1027-1035.
DeFronzo RA. Combination therapy with GLP-1 receptor agonist and SGLT2 inhibitor. Diabetes Obes Metab. 2017;19:1353-1362.
Perkins BA, Cherney DZ, Partridge H, et al. Sodium-glucose cotransporter 2 inhibition and glycemic control in type 1 diabetes: results of an 8-week open-label proof-of-concept trial. Diabetes Care. 2014;37:1480-1483.
Beitelshees AL, Leslie BR, Taylor SI. Sodium-glucose cotransporter 2 inhibitors: a case study in translational research. Diabetes. 2019;68:1109-1120.
Taghadom E, Al Kandari J, Murad S, et al. Impact of Dose Adjustment for Normal eating (DAFNE) courses on glycemia, incidence of severe hypoglycemia, and episodes of diabetic ketoacidosis in people with type 1 diabetes [abstract]. Sci Diabetes Self Manag Care. 2022;48:291.
Elliott J, Jacques RM, Kruger J, et al. Substantial reductions in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced costs after structured education in adults with type 1 diabetes. Diabet Med. 2014;31:847-853.
Jendle JH, Ampudia-Blasco FJ, Füchtenbusch M, Pozzilli P. Dapagliflozin as an adjunct therapy to insulin in patients with type 1 diabetes mellitus: efficacy and safety of this combination. TouchREV Endocrinol. 2021;17:12-20.
Miller KM, Foster NC, Beck RW, et al. Current state of type 1 diabetes treatment in the US: updated data from the T1D exchange clinic registry. Diabetes Care. 2015;38:971-978.
Ahrén B, Hirsch IB, Pieber TR, et al. Efficacy and safety of liraglutide added to capped insulin treatment in subjects with type 1 diabetes: the ADJUNCT TWO randomized trial. Diabetes Care. 2016;39:1693-1701.
Tuttle KR, Jones CR, Daratha KB, et al. Incidence of chronic kidney disease among adults with diabetes, 2015-2020. N Engl J Med. 2022;387:1430-1431.